Forehead cranioplasty is commonly accepted as the single most important procedure available for facial feminization. The recommended technique can be divided into its components of scalp advancement, anterior hairline rounding, orbital osteoplasty, glabellar setback, and brow lifting. The procedure is proven to be safe, effective, and well regarded by recipients. There are very few indications for preoperative imaging as an awareness of the relevant cranial anatomy coupled with the proven technique described herein provides for both safe and reliable results.